1,721,296 research outputs found
Palliative medicine and medical oncology
No full textTraditionally, medical oncology and palliative care have been considered two distinct and separate disciplines, both as regards treatment objectives and delivery times. Palliative care in terminal stages, aimed exclusively at evaluating and improving quality of life, followed antitumor therapies, which concentrated solely on quantitative results (cure, prolongation of life, tumoral mass shrinkage). Over the years, more modern concepts have developed on the subject. Medical oncology, dealing with the skills and strategic co-ordination of oncologic interventions from primary prevention to terminal phases, should also include assessment and treatment of patients' subjective needs. Anticancer therapies should be evaluated in terms of both the quantitative and qualititative impact on patients' lives. Hence, the traditional view of palliative care has to be modified: it constitutes a philosophical and methodological approach to be adopted from the early phases of illness. It is not the evident cultural necessity of integrating medical oncology with palliative medicine that may be a matter of argument, but rather the organizational models needed to put this combined care into practice: should continuous care be guaranteed by a single figure, the medical oncologist, or rather by an interdisciplinary providers' team, including full-time doctors well-equipped for palliative care? In this paper the needs of cancer patients and the part that a complete oncologist should play to deal with such difficult and far-reaching problems are firstly described. Then, as mild provocation, data and critical considerations on the ever increasing needs of palliative care, the present shortcomings in quality of life and pain assessment and management by medical oncologists, and the uncertain efficacy of interventional programmes to change clinical practice are described. Finally, a model of therapeutic continuity is presented, which in our view is realistic and feasible: an Oncologic Programme as the unifying process, and the Comprehensive Cancer Centre, or the Oncologic Department, the delivering structure
A hyperbolic model of multiphase flow
No full textWe consider a model for the flow of an inviscid fluid admitting liquid and vapor phases. We consider and prove here, as a preliminary study for a
forthcoming paper, the basic features of such a system:
wave curves, Riemann problem, wave interactions
Production and diffusion of scientific results in oncology
No full textThe production of data from oncological research must follow specific steps linked to the type of research carried out. Research can be subdivided into the following areas: translational research, clinical research (Phases I, II and III), pharmacoutilization research, meta-analy sis, and guidelines. A topic for discussion is represented by levels of evidence (LOE) of research, considered necessary for the transferral of therapeutic approaches to clinical practice. These involve production times of scientific research, and, in particular, the end-points deemed necessary by the appropriate regulatory bodies to permit the commercialization of drugs (problem of surrogate end-points). The interrelation between researchers and pharmaceutical companies has also recently become an object of reflection and research to find solutions that will guarantee both the independence of research and the legitimate needs of companies. A particularly important issue is the correct transmission of scientifically relevant data to the public by mass media sources. The communication of therapeutic advances obtained through research and scientific innovations should not lead to unrealistic expectations in the general population, which rather serve to weaken the already fragile relationship between the official world of oncology and the diverse universe of patients and their families
Hyperbolic phase-mixing flows: a global existence result for large data
No full textWe present a recent result about a model of one-dimensional
isothermal flow for an inviscid compressible fluid where the liquid and the vapor phase coexist and are mixed
together
On a model of multiphase flow
No full textWe consider a hyperbolic system of three conservation laws in one space variable. The system is a model for fluid flow allowing phase transitions; in this case the state variables are the specific volume, the velocity and the mass density fraction of the vapor in the fluid. For a class of initial data having large total variation we prove the global existence of solutions to the Cauchy problem
Prognosis in advanced cancer
No full textWhen considered with other parameters, prognostic factors of survival in far advanced cancer patients are necessary to enable the doctor, the patient, and his or her relative to choose the most suitable clinical management and care setting. Original studies and literature reviews, albeit with methodologic difficulties, have identified the most important prognostic factors as being: CPS, KPS, signs and symptoms relating to nutritional status (ie, weight loss, anorexia, dysphagia, xerostomia), other symptoms (dyspnea, cognitive failure) and some simple biologic parameters (serum albumin level, number of white blood cells and lymphocyte ratio). Some authors have weighed the different impact of the most important prognostic factors and have integrated them into prognostic scores for clinical use. Despite the usefulness of these instruments, however, the communication of a poor prognosis is one of the most difficult moments to face in the relationship between doctor and patient
Dose intensification in hormone receptor–negative and/or human epidermal growth factor receptor 2–negative high-risk primary breast cancer.
No full text[18F]fluorodeoxyglucose positron emission tomography for outcome prediction of mammalian target of rapamycin inhibitor therapy.
No full textA Note on Positive Solutions for Conservation Laws with Singular Source
No full textWe consider the Cauchy problem for the scalar conservation law
∂t u + ∂x f (u) = 1/g(u) , t > 0, x ∈ R,
with g ∈ C^1 (R), g(0) = 0, g(u) > 0 for u > 0, and assume that the initial datum u0 is nonnegative.
We show the existence of entropy solutions that are positive a.e., by means of an approximation of the equation that preserves positive solutions, and by passing to the limit using a monotonicity argument. The difficulty lies in handling the singularity of the right hand side (the source term) as
u possibly vanishes at the initial time. The source term is shown to be locally integrable. Moreover, we prove an uniqueness and stability result for the above equation
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